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. 2008 Oct 1;8(4):1–98.

Executive Summary Table 3: Overall Summary Statement of the Benefit and Risk for Patient-Directed Interventions*.

  Intervention Quality Benefits Risks/Burden Overall
Strength of
Recommendation
Section 3.1: Physical Exercise for Seniors with Dementia – Secondary Prevention Exercise – mix Moderate Improvement in functional, cognitive and behavioural outcomes Short-term follow-up and heterogeneity in studies

Unclear if leads to delayed institutionalization
Moderate
         
Section 3.2. Nonpharmacologic & Nonexercise Interventions to Improve Cognitive Functioning in Seniors with Dementia – Secondary Prevention Cognitive training Very low None Intervention does not offer significant benefit (possible type 2 error)

Unclear if leads to delayed institutionalization
Very low
Cognitive stimulation therapy (CST) Moderate/Low Increased cognition and quality of life Unclear how CST compares with past terminologies and methodologies. Low
        Short-term results.  
        Role and extent of maintenance CST.  
        Unclear how CST may impact functional dependence.  
        Unclear if leads to delayed institutionalization.  
Section 3.3. Physical Exercise for Delaying the Onset of Dementia – Primary Prevention Exercise – walking only High/Moderate Short-term decreased incidence of dementia Unknown if leads to delayed institutionalization. High/Moderate
Exercise – mix High/Moderate Short-term reduced risk of subsequent cognitive decline Unknown if leads to delayed diagnosis of dementia or institutionalization. High/Moderate
Exercise – mix Moderate Long-term decreased incidence of dementia Unknown if leads to delayed institutionalization. Moderate
Section 3.4. Nonpharmacologic & Nonexercise Interventions for Delaying the Onset of Dementia – Primary Prevention Cognitive interventions Low Cognitive improvements sustained after 5 years Results addressing functional outcomes unclear. Very low
        Need more than 5-year follow-up.  
      (however, none of these improvements had effects beyond the specific cognitive domains of the intervention) No evidence to determine if cognitive training leads to:
1) delayed diagnosis of dementia
2) delayed institutionalization